LEBANON

In November of last year, MSF expanded its work in Lebanon in order to provide urgent aid to thousands of Syrian refugees fl eeing across the border. Teams opened new medical projects in the northern Wadi Khaled area, in Tripoli, and in various locations in the Bekaa Valley.

Living conditions are extremely precarious for many refugees. According to MSF estimates, in early September more than 1,000 people were living in overcrowded shelters close to the border in the villages of Wadi Khaled and in the Bekaa Valley. In Tripoli, rental costs are high and many families have no choice but to share apartments. Access to medical care is also lacking. A study undertaken by MSF this past May showed that the availability of treatment for chronic diseases such as asthma, diabetes, hypertension, and cardiovascular disease is a major concern, and that four in ten interviewees did not have access to a hospital. “The refugees are really being tested,” said Fabio Forgione, MSF’s head of mission in Lebanon. “When they arrive, most are struggling to deal with the consequences of direct violence and loss; then they have to face the reality of not being able to go home. Many lose all hope.”

“When they arrive, most are struggling to deal with the consequences of direct violence and loss; then they have to face the reality of not being able to go home. Many lose all hope.”

While Lebanese communities have made a tremendous eff ort to integrate and help refugees, there are limits on what they can do. Humanitarian relief and the support of host communities has been an important factor in avoiding a major health crisis thus far, but any reduction in assistance could place refugees at risk. For the moment, the reality for many Syrian refugees in Lebanon is a life on the brink—an escape from one set of dangers and uncertainties to another.

JORDAN

Syrian refugees have been arriving in Jordan on an almost daily basis, using different routes to get in but almost always ending up in one of the camps set up at the border crossing in the Jordanian town of Ramtha.

A specialized MSF surgical team performs operations in a hospital in nearby Amman. Initially, the team performed only reconstructive surgery, treating victims of violence from Iraq, Libya, Yemen, and other countries [see page 14]. However, the number of Syrian refugees arriving in Jordan with bullet wounds and other injuries has grown steadily since the revolt broke out in their country.

““...the number of Syrian refugees arriving in Jordan with bullet wounds and other injuries has grown steadily since the revolt broke out in their country.”

As a result, MSF has strengthened its orthopedic surgery team in Amman. An MSF surgeon examines five to ten patients per week at the hospital, and about one-third of those patients require orthopedic surgery—either for the fi rst time, or in addition to a previous surgery conducted elsewhere. Another third receive physical therapy, and the remaining third are closely monitored as they rehabilitate.

MSF teams also regularly visit the camps on the border to speak with potential patients. They are, in truth, more like transit centers than camps; Syrians generally do not stay very long.